# RAINBOW DENTAL PARTNERS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Boca Dental and Braces
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306471826
- **Authorized official:** DIANA JESSENIA CAZZALY (GENERAL MANAGER OF OPORATIONS)
- **Authorized official phone:** (702) 456-0005

## Contact information

- **Practice address:** 3163 N RAINBOW BLVD, LAS VEGAS, NV 89108-4578
- **Practice address phone:** (702) 805-1178
- **Practice address fax:** (702) 763-8885
- **Mailing address:** 4750 W SAHARA AVE STE 12, LAS VEGAS, NV 89102-3559
- **Mailing address phone:** (702) 456-0005
- **Mailing address fax:** (702) 763-8885

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 03/04/2020
- **Last updated:** 03/04/2020